Yoga may reduce fatigue after breast cancer

NEW YORK (Reuters Health) - Participating in yoga classes
after treatment for breast cancer was linked to reduced fatigue
and inflammation and increased vitality among women in a new
study.

Researchers found that breast cancer survivors who took 12
weeks of yoga classes ended up with reduced inflammation and
felt less tired after six months, compared to a similar group of
women who didn't take yoga classes.

"This may be a way to provide a good activity that also has
other benefits," Janice Kiecolt-Glaser, the study's lead author,
told Reuters Health.

Kiecolt-Glaser is an investigator at The Ohio State
University Comprehensive Cancer Care Center and the Institute
for Behavioral Medicine Research in Columbus.

She and her colleagues write in the Journal of Clinical
Oncology that cancer survivors are twice as likely to have poor
health and more disability, compared to people without a history
of cancer.

That may be partially explained by less exercise and
activity during and after cancer treatment, which may increase
inflammation throughout the body. Chronic inflammation has been
tied to increased risks for death and a number of health
disorders.

Previous research has also found that inflammation tends to
be elevated among cancer survivors and people who don't do a lot
physical activity.

Yoga may be one way to get breast cancer survivors moving
again, because its intensity can be tailored to an individual's
limits. Yoga has also been linked to reduced fatigue among
cancer survivors through better sleep (see Reuters Health story
of Aug. 30, 2013 here: http://reut.rs/16Xrk56.)

To see whether yoga had an effect on inflammation, mood and
fatigue, the researchers recruited 200 breast cancer survivors,
who finished their treatments at least two months before the
study began in 2008.

The women were randomly assigned to one of two groups that
either participated in two weekly 90-minute yoga sessions for 12
weeks or were put on a waiting list and told to avoid yoga.

The women's blood was analyzed for indications of
inflammation. They also answered a series of surveys and
questionnaires to measure their fatigue, vitality and mood.

At the end of 12 weeks, the researchers found that women
taking the yoga classes scored higher than the comparison group
for vitality. But there were no significant differences between
the groups in measurements of mood, fatigue or inflammation.

Another three months after the yoga classes ended, however,
women in the yoga group were less fatigued and had higher
vitality scores than women in the comparison group.

For example, before anyone did yoga, both groups of women
scored about 14 on a fatigue scale of 0 to 30, where higher
scores indicate greater fatigue. At the end of the study, the
average score among women in the yoga group was five, versus
about 13 among women in the comparison group.

There was no difference between the groups in mood, but
Kiecolt-Glaser said the women weren't depressed enough at the
start of the study to leave room for improvement.

In addition to feeling less tired, the researchers found
that at six months the indicators of inflammation in the yoga
participants' blood samples were between 13 percent and 20
percent lower than those in the comparison group.

"My best guess is that when women are sleeping better
they're less fatigued and their inflammation goes down,"
Kiecolt-Glaser said, adding that the more often the women did
yoga weekly, the better their results.

While Kiecolt-Glaser said the women in the study would
notice a difference in their fatigue after the study, she added
that it would be difficult to know if the lower inflammation led
to noticeable differences. That would require longer studies.

Karen Mustian, who was not involved in the study but has
researched yoga among cancer survivors, said it's also important
to find out how yoga affects the body.

"We really need to be able to drill down and understand how
it works to be able to more accurately prescribe these
interventions," said Mustian, who is from the James P. Wilmot
Cancer Center at the University of Rochester Medical Center in
New York.

She also said yoga can be recommended to breast cancer
survivors as long as they're aware of some caveats, including
that they should pick a low-to-moderate intensity yoga,
understand their physical limitations and do their research to
find a credentialed and trained yoga instructor.

"Yoga is certainly an excellent intervention to try when
women are feeling fatigued post treatment," Kiecolt-Glaser said.
"But in general even for women and men who aren't cancer
survivors, it may be an excellent intervention if they're
feeling fatigued and (have) declined to take part in something
more vigorous."